Making the Decision to Have a Stem Cell Transplant for Acute Lymphocytic Leukemia (ALL)

You should know that stem cell transplants are somewhat controversial. Your doctor may suggest one in these situations.

• You do not respond to other therapies.

• You have ALL with the Philadelphia chromosome. This genetic defect means the prognosis is not as good, so you may require a more radical treatment plan.

• You have a matched stem cell donor ready. If this is the case, the doctor may recommend having the transplant as soon as you go into your first remission. If you don’t have a matched donor or have decided for other reasons not to have the transplant right away, you may wait to see if the first remission lasts.

• You have a relapse after your first remission. It is likely your doctor will strongly recommend a transplant after a second remission is induced.

• You’re young enough to withstand the side effects of a stem cell transplant.

• You’ve discussed the risks and potential side effects with your doctor and feel you are willing to proceed.

Stem cell transplants are complex procedures. They require the services of specialized doctors called bone marrow transplant specialists. If you decide to have one, be sure to go to a hospital that specializes in stem cell transplants, such as a major cancer center. These hospitals are accredited by the Foundation for the Accreditation of Cellular Therapy (FACT). The procedure is also expensive (about $100,000), and not all insurance companies cover the cost.